Many jurisdictions require an autopsy to be performed to assure that death was from natural or accidental causes, and an autopsy is sometimes requested or permitted by the family of the deceased, even though not legally required. It is not unusual for a Medical Examiners' office, in an urban area, to perform a number of autopsy examinations a day.
Most autopsy examinations require examination of the brain. For examination of the brain, a cut is made around the hollow upper portion of the skull bone, usually slightly above the region of maximum diameter, and the resulting skullcap is lifted and removed to expose the brain for examination and/or removal.
The technician and a pathologist or Medical Examiner usually work together during an autopsy. The technician does the skullcap cutting and the bone cutting necessary to open the chest cavity, to remove the organs for examination.
The know technique for cutting a skullcap is to draw a line around the skull and then cut along the line with an autopsy saw which is a hand held electric motor driven oscillating blade saw, that is alleged to cut bone without cutting adjacent soft tissue. The technician does the skullcap cutting with this saw, usually by cutting around the skull several times until the skull bone is severed to remove the skullcap. Sometimes, the skull is not cut completely through at all locations. When only a thin section or sections of bone remain, a T-blade can be used to break the remaining sections and pry off the skullcap.
Cutting the skullcap in this known manner is time consuming and tedious, because the oscillating blade cuts bone very slowly, and significant pressure is required to cut the bone. The time required to cut the skullcap in this manner is about thirty minutes. Cutting the skullcap requires constant attention, and is uncomfortable for the technician because the part of the autopsy saw gripped by the hand of the technician becomes quite hot, when the autopsy saw is operated for such long periods of time. Further, considerable skill is required to avoid damaging brain tissue, and an unskilled or careless technician can cause cosmetic damage to the head which is difficult for a mortician to repair and conceal.
Since the skullcap is cut while the body is on an autopsy table or at an autopsy station, the table or station is not available for other autopsy work, and the number of autopsy examinations that can be performed at a facility is often limited by the time required for skullcap cutting. It is more significant that the pathologist or medical examiner must often wait for the skullcap to be cut, and it is common practise for a pathologist or Medical Examiner to do only one autopsy at a time, to avoid any possibility of intermixing data or organs of different cadavers. Because of the relatively high overhead factors of such facilities, skullcap cutting and removal at present is quite expensive, and is often the cause of a backlogs for Medical Examiners.